Wednesday, October 5, 2011

[EQ] Health in All Policies: South Australia's country case study on action on the social determinants of health

Health in All Policies:
South Australia's country case study on action on the social determinants of health

Kevin Buckett, Carmel Williams, Deb Wildgoose
Health in All Policies, Department of Health; Adelaide, Australia
Background paper: WHO - World Conference on Social Determinants of Health, 19-21 October 2011, Rio de Janeiro, Brazil

Available online PDF [21p.] at:

“……The successful adoption and implementation of Health in All Policies (HiAP) in South Australia (SA) has been influenced by the following four essential factors:
- a high level mandate from central government,
- an overarching policy framework which can accommodate health lens application to diverse program areas,
- a commitment to work collaboratively and in partnership across agencies, and
- a strong evaluation process.

This represents a practical and applied inter-sectoral approach to complex policy issues.

As is the case for many other countries and jurisdictions, the South Australian health system is struggling with escalating health care costs, the growing burden of an ageing population and an increasing incidence of chronic disease. At the same time the evidence base has been clearly documenting that the best opportunities to change the dynamics that influence health lay outside the direct control of the health sector. The social determinants of health provide the social, economic and environmental levers to influence population health outcomes.

It was within this context that Professor Ilona Kickbusch proposed that South Australia adopt a HiAP approach and that this approach be applied to targets contained within South Australia’s Strategic Plan (SASP); the Government’s overarching vision for its State.

The unique advantage of this proposal was the significant and strategic importance of SASP to all South Australian government agencies. SASP contains 98 targets under 6 objectives and there is comfortable alignment between the SASP objectives and the social determinants of health. Oversight for HiAP was placed under the auspices of the high level committee (the Executive Committee of Cabinet) responsible for overseeing the implementation of SASP, reflecting the strategic importance of the work.

Investing in building strong inter-sectoral relationships provides an opportunity to explore some of the interconnections between the SASP targets, and to identify joint areas of work to achieve a win-win solution; that is to work towards the achievement of partner agencies’ targets as well as improve the health of the population. HiAP provides a mechanism for agencies to jointly reflect on a particular policy issue, and work in a collaborative and deliberative way to determine issues and take timely and proper policy decisions. …..”


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